Fractal dimension, lacunarity, and cortical thickness in the mandible: Analyzing differences between healthy men and women with cone-beam computed tomography

Purpose@#The objective of this study was to assess the fractal dimension, lacunarity, trabecular microarchitecture parameters, and cortical linear measurements in the mandibles of male and female individuals to identify differences between them. @*Materials and Methods@#In total, 116 cone-beam computed tomography scans of healthy individuals of different ages (57 men and 59 women, aged between 20 and 60 years) were selected. The following bone parameters were measured: 1) buccal, lingual, and basal cortical bone thickness in 5 standard parasagittal sections (the midline, the left and right sides of the lower lateral incisors, and the left and right sides of the lower canines); 2) the bone volume fraction of 10 sequential axial sections from each patient by creating a volume of interest in the area between the lower canines; and 3) fractal dimension and lacunarity using grayscale images of the same region of the volume ofinterest in the anterior mandible. Spearman correlation coefficients and the Mann-Whitney test were used. @*Results@#A significant and positive correlation was found between age and cortical thickness, especially in the region of the central incisors. Significant differences between sexes in terms of fractal dimension, lacunarity, and bone volume were found. Women revealed lower fractal dimension values and higher lacunarity and bone volume ratiovalues than men. @*Conclusion@#Fractal dimension, lacunarity, trabecular bone volume, and cortical thickness were different between men and women of different ages. (Imaging Sci Dent 2023; 53: 153-9)

The effect of the die material used in the indirect technique on the fracture resistance of a restored molar

Abstract The aim of this study was to evaluate the effect of different die materials used in the indirect resin composite restorative technique on the fracture resistance and failure mode of restored molars and compare it with the direct resin composite restorative technique. Two flexible die silicone materials for dental models (Die Silicone - Voco and Scan die - Yller) and a type IV dental stone material (Fujirock EP - GC) were evaluated. Sixty third molars were selected and divided into four groups: indirect resin composite restoration - Die silicone (IRCR-DS); indirect resin composite restoration - Scan die (IRCR-SD); indirect resin composite restoration - Fujirock EP (IRCR-FR), and direct resin composite restoration (DRCR). Class II MOD cavities were prepared with 5 mm of buccolingual width and depth. The specimens were restored and subjected to an axial compression load until fracture, and the data were analyzed by one-way ANOVA and Tukey's HSD test (α=.05). The fracture mode was classified into restorable and unrestorable fractures. Fracture resistance values were influenced by the die material used for the IRCR fabrication and by the restorative technique (p<.001). Fracture resistance mean values and standard deviation were: IRCR-DS: 1835.5 ± 324.0 A; IRCR-SD: 1732.5 ± 384.1 AB; IRCR-FR: 1419.3 ± 318.8 BC; and DRCR: 1100.6 ± 224.9 C. Restorable fracture was more prevalent. IRCR with flexible die casts promoted higher fracture resistance and lower prevalence of unrestorable fractures.

Factors associated with the morphology of the mandibular symphysis and soft tissue chin

ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.

RESUMO Introdução: O presente estudo objetivou: 1) avaliar a morfologia da sínfise mandibular e dos tecidos tegumentares do mento, associada ao sexo, idade, padrões sagital e vertical; e 2) identificar as contribuições dessas variáveis, individualmente ou combinadas, às diferentes regiões da sínfise. Métodos: Este estudo transversal incluiu 195 radiografias cefalométricas laterais de adultos não tratados ortodonticamente. Os tecidos alveolar, basal e mole da sínfise foram medidos por um sistema de coordenadas x, y e z da base do crânio e divididos de acordo com quatro variáveis preditoras: sexo, idade e padrões esqueléticos sagitais e verticais. Testes paramétricos foram conduzidos para fins de comparação e correlação, enquanto a análise de regressão múltipla foi realizada para explorar as interações combinadas. Resultados: A inclinação alveolar está relacionada aos padrões sagitais e verticais, e ambos explicaram 71,4% das variações. A espessura alveolar é fracamente prevista e pouco influenciada pela idade. A altura da sínfise foi 10% maior no sexo masculino e esteve associada ao padrão esquelético vertical e ao sexo, sendo que ambos explicaram 43,6% das variações. A sínfise basal mostra espessura individual, é maior no sexo masculino e verticalmente curta com a idade. O tecido mole do mento não está necessariamente relacionado ao tamanho do padrão esquelético subjacente e aumenta com a idade, mesmo na idade adulta. Conclusões: A sínfise e os tecidos circundantes são influenciados pelo sexo, idade e padrões sagitais e verticais, que atuam de forma diferenciada nas porções alveolar, basal e de tecidos tegumentares. Os padrões esqueléticos sagitais e verticais são a associação mais forte na inclinação da sínfise alveolar, enquanto o sexo e a idade atuam na posição vertical da sínfise e na espessura dos tecidos tegumentares.

Gynecological Surgery and Its Five Steps Towards Resilience:Minimally Invasive Approach in the COVID-19 Era

After the declaration of the coronavirus disease 2019 (COVID-19) pandemic, gynecological surgery joins the readjustment process that this great global health crisis implies. In the light of current literature, the five steps towards its resilience are described as below; (1) Dynamic prioritization of surgical indications and reintroduction of elective surgeries: Diverse surgical prioritization lists are published including the most common gynecological pathologies. (2) Minimally invasive surgery through laparoscopy and robotic assistance: Some authors suggest a theoretical but unproven risk of viral transmission during these approaches because of the aerosol generation. These theories are opposed to the well-proven advantages of these approaches compared to open surgery. (3) Optimization of surgical procedures, according to the recommendations of different societies aimed at reducing the dispersion of aerosols and surgical smoke. (4) Clinical, epidemiological and microbiological screening of all patients awaiting prompt surgery: This screening should be adapted to the local alert state. (5) Protection through the reduction of number of persons present in the operating room, and the use of adapted personal protective equipment according to physical proximity to the patient.

Gynecological Surgery and Its Five Steps Towards Resilience:Minimally Invasive Approach in the COVID-19 Era

After the declaration of the coronavirus disease 2019 (COVID-19) pandemic, gynecological surgery joins the readjustment process that this great global health crisis implies. In the light of current literature, the five steps towards its resilience are described as below; (1) Dynamic prioritization of surgical indications and reintroduction of elective surgeries: Diverse surgical prioritization lists are published including the most common gynecological pathologies. (2) Minimally invasive surgery through laparoscopy and robotic assistance: Some authors suggest a theoretical but unproven risk of viral transmission during these approaches because of the aerosol generation. These theories are opposed to the well-proven advantages of these approaches compared to open surgery. (3) Optimization of surgical procedures, according to the recommendations of different societies aimed at reducing the dispersion of aerosols and surgical smoke. (4) Clinical, epidemiological and microbiological screening of all patients awaiting prompt surgery: This screening should be adapted to the local alert state. (5) Protection through the reduction of number of persons present in the operating room, and the use of adapted personal protective equipment according to physical proximity to the patient.

Removal of a melee weapon forgotten in the orbital cavity: case report / Remoção de arma branca esquecida em órbita: relato de caso

ABSTRACT Facial aggressions perpetrated with melee weapons cause injuries that are difficult to treat. Possible aesthetic-functional sequels can cause irreparable damage to the patients. This study presents a case of a patient who suffered physical aggression resulting in a fracture caused with a knife in the orbital cavity that had not been diagnosed during emergency healthcare. After nine months of the primary trauma, the patient developed a fistula in the eyelid region due to infection. The surgery for removal of the foreign body was performed under general anaesthesia and the object was removed through subtarsal approach without causing structural damage to the patient. After satisfactory tissue healing, the treatment was discontinued.

RESUMO As agressões faciais oriundas de arma branca constituem lesões de difícil tratamento. As possíveis sequelas estético-funcionais podem acarretar danos irreparáveis ao paciente. Este trabalho tem como escopo apresentar um caso de um paciente que sofrera agressão física resultando em fratura por arma branca dentro da cavidade orbitária que não fora diagnosticada durante o atendimento primário emergencial. Após nove meses do trauma primário, o mesmo desenvolveu fístula na região palpebral devido a infecção. A cirurgia para remoção do corpo estranho foi realizada sob anestesia geral e o objeto removido através do acesso subtarsal sem acarretar danos estruturais ao paciente. Após a cicatrização tecidual satisfatória, paciente recebeu alta do tratamento.

Analysis of sex-related differences in external load demands on beach handball / Análise das diferenças relacionadas ao sexo nas demandas de carga externa no handebol de praia

Abstract The purpose of the present study was to analyze the sex-related differences in beach handball workload. A total sample of 105 handballers (male, n=50; female, n=55) belonging to six U'16 teams, seven U'18 teams and eight senior teams were monitored in the final round of 2018-2019 beach handball tournament celebrated during 3-days congested-fixture design. The external load variables Steps, Jumps, Player Load, Total Impacts (>2G) and Total Impacts per Intensities (very low, 2-4G; low, 4-6G; moderate, 6-8G; high, 8-10G; very high, >10G) through WIMUTM inertial devices. Statistical analysis was composed by t-test and Cohen's d for anthropometrical variables and by MANOVA and omega partial square for sex and categories related differences. Greater values in male handballers were found in height, weight and age in each categories (U'16: p<0.05; d=0.50-2.26; U'18: p<0.05; d=0.95-2.21; senior: p<0.05; d=1.01-1.99), except in age in U'18 (p=0.97; d=0.01). Respect to external workload, differences were found related to category (p<0.01; ωp²= 0.02-0.05, small) and sex (p<0.01; ωp²= 0.04-0.21, small to high), except in Steps (p=0.47; ωp²= 0.00), finding the greatest sex-related differences in U'16 category. From the differences found in anthropometrical characteristics and external workload, their evaluation during competition allows designing specific training sessions with the purpose of sports performance enhancement in beach handball.

Resumo Objetivou-se analisar as diferenças relacionadas ao sexo na carga de trabalho de handebol de praia. Uma amostra total de 105 jogadores de handebol (masculino, n = 50; feminino, n = 55) pertencentes a seis equipes sub-16, sete equipes sub-18 e oito equipes seniores foi monitorada na rodada final do torneio de handebol de praia 2018-2019 durante 3 dias de projeto. As variáveis ​​de carga externa Etapas, Saltos, Carga do jogador, Impactos totais (> 2G) e Impactos totais por intensidade (muito baixo, 2-4G; baixo, 4-6G; moderado, 6-8G; alto, 8-10G; muito alto,> 10G) foram mensurados por meio de dispositivos inerciais WIMUTM. A análise estatística foi composta pelo teste t, d de Cohen e MANOVA. Maiores valores nos handebolistas masculinos foram encontrados em estatura, massa corporal e idade em cada categoria (U'16: p <0,05; d = 0,50-2,26; U'18: p <0,05; d = 0,95-2,21; sénior: p <0,05 ; d = 1,01-1,99), exceto na idade nos U'18 (p = 0,97; d = 0,01). No que diz respeito à carga de trabalho externa, foram encontradas diferenças relacionadas à categoria (p <0,01; ωp² = 0,02-0,05, pequeno) e sexo (p <0,01; ωp² = 0,04-0,21, pequeno a alto), exceto nas etapas (p = 0,47; ωp² = 0,00), encontrando as maiores diferenças relacionadas ao sexo na categoria U'16. A partir das diferenças encontradas nas características antropométricas e na carga de trabalho externa, sua avaliação durante a competição permite projetar sessões de treinamento específicas com o objetivo de melhorar o desempenho esportivo no handebol de praia.

Úlcera vulvar aguda de Lipschütz / Acute vulvar ulcer of Lipschütz

RESUMEN La úlcera de Lipschütz es una entidad poco frecuente e infradiagnosticada. Se presenta el caso de una paciente de 24 años sin antecedente de contacto sexual que consultó por aparición súbita de úlceras vulvares dolorosas, en el contexto de un cuadro pseudogripal. Se discuten los principales diagnósticos diferenciales, dado que es una enfermedad no relacionada con enfermedades de transmisión sexual y poco reconocida por los profesionales de la salud, que precisa de manejo conservador.

ABSTRACT Lipschütz ulcer is a rare underdiagnosed entity. We present the case of a 24-year-old patient without history of sexual contact who consulted for sudden occurrence of painful vulvar ulcers, in the context of flu-like symptoms. The main differential diagnoses are discussed, as it is a disease unrelated to sexually transmitted diseases and little recognized by health professionals, which requires conservative management.

Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts

PURPOSE: This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. MATERIALS AND METHODS: Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups (VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. RESULTS: The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P < .05). The least interference due to artifact formation was observed using protocol 2. CONCLUSION: Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.

Sexually transmitted pathogens, coinfections and risk factors in patients attending obstetrics and gynecology clinics in Jalisco, Mexico / Patógenos de transmisión sexual, coinfecciones y factores de riesgo en pacientes que asisten a clínicas de obstetricia y ginecología en Jalisco, México

Abstract: Objective: To determine the frequency of nine sexually transmitted pathogens, coinfections and risk factors in patients attending obstetrics and gynecology clinics in Jalisco, Mexico. Materials and methods: Samples from 662 patients attending obstetrics and gynecology clinics were analyzed. Treponema pallidum, HIV, and HCV were detected by serology. HPV was detected by Polimerase Chain Reaction (PCR), and its genotype was determined by Restriction Fragment Length Polymorphism (RFLP). Trichomonas vaginalis, HSV-1, HSV-2, Mycoplasma genitalium, Neisseria gonorrhoeae and T. pallidum were detected by multiplex PCR. Results: By serology, HIV frequency was 6.8%, T. pallidum was 2.26%, and HCV was 0.15%. By PCR, HPV frequency was 13.9%, (more frequent genotype was 16, 33.7%), followed by T. vaginalis (14.2%), HSV-1 (8.5%), M. genitalium (2,41%), N. gonorrhoeae (2.11%), HSV-2 (1.8%), and T. pallidum (1.05%). Patients infected with T. vaginalis were more likely to have multiple coinfections (p = 0.01). Conclusion: The frequency of HPV, HVS-1, HSV-2, M. genitalium and T. vaginalis was lower than that reported. However, a high frequency of HIV, T. pallidum, and N. gonorrhoeae was detected.

Resumen: Objetivo: Determinar la frecuencia de nueve patógenos de transmisión sexual, coinfecciones y factores de riesgo en pacientes que acudieron a una consulta de ginecología y obstetricia en Jalisco, México. Material y métodos: Se analizaron muestras de 662 pacientes que asistieron a la consulta de ginecología y obstetricia. Se detectaron Treponema pallidum, VIH y VHC mediante serología. Se detectó VPH por Reacción de Cadena de Polimerasa (PCR) y sus genotipos se detectaron por Polimorfismos de Longitud de Fragmentos de Restricción (RFLP). Se detectaron Trichomonas vaginalis, VHS-1,VHS-2, Mycoplasma genitalium, Neisseria gonorrhoeae y T. pallidum por PCR múltiple. Resultados: Por serología, la frecuencia deVIH fue 6.8%, de T. pallidum fue 2.26% y deVHC fue 0.15%. Por PCR, la frecuencia más alta fue deVPH (13.9%, el genotipo más frecuente fue el 16, 33.7%), seguida deT. vaginalis (14.2%), VHS-1 (8.5%), M. genitalium (2.41%), N. gonorrhoeae (2.11%), VHS-2 (1.8%) y T. pallidum (1.05%). Los pacientes infectados con T. vaginalis presentaron más probabilidades de tener múltiples coinfecciones (p = 0.01). Conclusiones: La frecuencia de infección por VPH, VHS-1,VHS-2, M.genitalium y T. vaginalis fue menor a lo reportado. Sin embargo, se detectó una alta frecuencia de VIH, T. pallidum, y N. gonorrhoeae.

Repercussões da máscara nasal e oronasal sobre a patência da via aérea superior durante uso de pressão positiva contínua para o tratamento de pacientes com apneia obstrutiva do sono / Impact of the nasal and oronasal mask on the patency of the upper airway during continuous positive airway pressure on treatment of patients with obstructive sleep apnea

A aplicação de Pressão Positiva Contínua nas Vias Aéreas Superiores (CPAP) durante o sono é o padrão ouro no tratamento da Apneia Obstrutiva do Sono (AOS) e foi primeiramente descrito utilizando uma máscara nasal. No entanto, na prática clínica a máscara oronasal é comumente. Este estudo foi desenhado para determinar os efeitos agudos da mudança de rota de fluxo do CPAP de nasal para oronasal e oral na patência da via aérea superior durante o sono em pacientes com AOS. Nós hipotetizamos que a pressão transmitida pelo compartimento oral da máscara oronasal pode comprometer a eficácia do CPAP no tratamento da AOS por empurrar a língua posteriormente. Métodos: Dezoito pacientes (idade 44 ± 9 anos, índice de massa corpórea de 33,8 ± 4,7 kg / m², índice de apneia-hipopneia 49,0 ± 39,1 eventos/hora) dormiram com máscara oronasal customizada com dois compartimentos (nasal e oral) selados e independentes conectados a uma válvula multidirecional. O sono dos pacientes foi monitorizado pela polissonografia e induzido por baixas doses de midazolam (3,1 ± 2,2 mg). O CPAP nasal foi titulado até a pressão de manutenção das vias aéreas superiores. A rota de fluxo do CPAP foi mudada de nasal para oronasal (n = 18) e oral (n = 16) durante o sono. A área retroglossal foi continuamente observada durante a nasoendoscopia. Resultados: O CPAP nasal (14,8 ± 4,1 cmH2O) foi suficiente para estabilizar a via aérea superior em todos os pacientes. Em contraste, o CPAP oronasal e oral promoveram eventos obstrutivos em 12 (66,7%) e 14 (87,5%) pacientes, respectivamente. Quando o CPAP foi transmitido pela rota oronasal e oral houve uma redução progressiva e significante na distância entre a epiglote e a base da língua e na área retroglossal em comparação com a respiração estável durante a rota nasal. Conclusões: Mudanças agudas na rota de fluxo do CPAP nasal para as rotas oronasal e oral induzem eventos obstrutivos e diminuem as dimensões da orofaringe em pacientes com AOS...

Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA) and was conceived to be applied by nasal route only. However, in clinical practice the oronasal mask is commonly used. This study was designed to determine the acute effects of changing the nasal CPAP route to oronasal and oral in upper airway patency during sleep in patients with. We hypothesized that the pressure transmitted by the oral compartment of oronasal mask will push the tongue backwards and will compromise CPAP effectiveness in OSA treatment. Methods: Eighteen patients with OSA (age: 44±9 years44±9 years44±9 years44±9 years44±9 years44±9 years44±9 years44±9 years44±9 years , body mass index: 33.8±4.733.8±4.733.8±4.7 33.8±4.7 33.8±4.7 Kg/m², apnea-hypopnea index: 49.0 ± 39.149.0 ± 39.149.0 ± 39.149.0 ± 39.149.0 ± 39.149.0 ± 39.1 49.0 ± 39.149.0 ± 39.149.0 ± 39.1 events/hour) slept with a customized oronasal mask with a nasal and oral sealed compartments connected to a multidirectional valve. Sleep was monitored by full polysomnography and induced by low dosis of midazolam (3.1 ± 2.2 mg). Nasal CPAP was titrated up to holding pressure and flow route was changed to oronasal (n = 18) and oral route (n = 16) during sleep. Retroglossal area was continuously observed by nasoendoscopy. Results: Nasal CPAP (14.8±4.1 cmH2O) was able to stabilize breathing in all patients. In contrast, CPAP delivered by oronasal and oral route promoted obstructive events in 12 (66.7%) and 14 (87.5%) patients, respectively. Compared to stable breathing during nasal route, there was a significant and progressive reduction in the distance between epiglottis and tongue base and the retroglossal area when CPAP was delivered by oronasal and oral route, respectively. Conclusions: CPAP delivered by oronasal route may compromise CPAP effectiveness to treat OSA...

Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea / O impacto do tipo de máscara na eficácia e na adesão ao tratamento com pressão positiva contínua nas vias aéreas da apneia obstrutiva do sono

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

O tratamento com continuous positive airway pressure (CPAP, pressão positiva continua nas vias aéreas) é o padrão ouro na apneia obstrutiva do sono (AOS). Apesar de a CPAP ter sido originalmente aplicada através de máscara nasal, várias interfaces são atualmente disponíveis. Revisamos conceitos teóricos e questionamos a premissa de que todas as máscaras produzem resultados semelhantes. Compilamos as evidências na literatura sobre o impacto do tipo de máscara na eficácia e na adesão ao tratamento com CPAP em pacientes com AOS. Foram pesquisados artigos escritos em inglês na base de dados PubMed com as palavras-chave "CPAP", "mask" e "obstructive sleep apnea". Dos 91 artigos encontrados, somente 12 foram selecionados por descrever o impacto do tipo de máscara sobre a efetividade (n = 6) ou a adesão (n = 6) ao tratamento. Apesar de alguns resultados conflitantes, não encontramos efeitos significativos da máscara pillow nasal e da máscara oral na eficácia ou adesão ao tratamento da AOS. Em contraste, a maior parte dos estudos mostrou que a máscara oronasal é menos efetiva e mais frequentemente associada a menor adesão e maior abandono do tratamento do que a máscara nasal. Concluímos que a máscara oronasal pode comprometer a eficácia e a adesão ao tratamento da AOS com CPAP. Estudos futuros são necessários para a compreensão dos mecanismos exatos envolvidos neste efeito. .

Impact of cone-beam computed tomography on implant planning and on prediction of implant size

The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning.

Alto desempenho gerencial, contexto desafiador e personalidade / High performance management, challenging environment and personality / Alto desempeño gerencial, contexto desafiador y personalidad

O presente artigo apresenta resultados de um estudo sobre aspectos da personalidade correspondentes do alto desempenho gerencial e, consequentemente, preditores de sucesso nessa área de atuação profissional. Foram avaliados 43 gerentes considerados de alto desempenho em suas avaliações, por seus superiores e pares, de empresas brasileiras de grande porte. Focaram-se os aspectos da personalidade relativos às capacidades de: análise, planejamento, iniciativa, relacionamento interpessoal e integração humana. Os resultados obtidos permitiram constatar que esses gerentes são produtivos e ativos, capazes de analisar, planejar e tomar iniciativa, destacando-se a alta habilidade de perceber relações entre as partes, articulá-las de maneira organizada e eficiente na solução de problemas mesmo em condições adversas; demonstram capacidade de trabalhar em equipe de modo cooperativo, sendo que 50% da amostra possui boas condições de relacionamento interpessoal. A associação dessas capacidades em contexto desafiador parece caracterizar o alto desempenho gerencial contemporâneo...

This paper presents results of a study on aspects of personality matching top management performance and, consequently, predictors of success in this area of professional practice. We studied 43 managers considered high performance in their evaluations by their superiors and peers, in large brazilian companies. Have focused on aspects of personality related to capabilities: analysis, planning, initiative, interpersonal relationships and human integration. The results revealed that these managers are productive and active, able to analyze, plan and take initiative, highlighting the high ability to perceive relations between them, articulate them in an organized and efficient in solving problems even in adverse; demonstrate ability to work cooperatively in teams, and 50% of the sample has good interpersonal relationship. The combination of these capabilities in challenging context seems to characterize the contemporary high-performance management...

El presente artigo retrata resultados de un estudio sobre los aspectos de la personalidad correspondientes al alto desempeño gerencial y, consecuentemente, predictores de suceso en esta área de actuación profesional. Fueron evaluados 43 gerentes considerados de alto desempeño en sus evaluaciones, por sus superiores y pares, de empresas brasileiras de grande porte. El ponto central de investigación fue los aspectos de la personalidad relativos a las capacidades de: análisis, planeamiento, iniciativa, relacionamiento interpersonal e integración humana. Los resultados permitieron constatar que estos gerentes son productivos y activos, capaz de analizar, planear y tomar iniciativa, se destacando por la alta habilidad de darse cuenta de las relaciones entre las partes, articularlas de manera organizada y eficiente en la solución de problemas mismo en condiciones adversas; demuestran capacidad de trabajar en equipe de modo cooperativo, siendo que 50% de la muestra tienen buenas condiciones de relacionamiento interpersonal. La asociación de estas capacidades nun contexto desafiador parece caracterizare el alto desempeño gerencial contemporáneo...

Excelência Humana: A Contribuição da Personalidade / Human Excellence: The Contribution of Personality / Excelencia Humana: La Contribución de la Personalidad

Este estudo teve por objetivo analisar, sob o enfoque da Psicologia Positiva, as explicações dos pesquisadores da excelência humana sobre o que a promove e a mantém nos mais variados domínios de atuação. Constatou-se que fatores pessoais e contextuais são mencionados, destacando-se as habilidades cognitivas e a prática deliberada no desempenho superior, sendo também as variáveis de personalidade decisivas para o desenvolvimento e a manifestação da excelência. Neste estudo, como na literatura na área, destaca-se a importância da persistência, controle emocional e abertura à experiência.

This paper presents an analysis from the perspective of Positive Psychology of explanations from researchers concerning human excellence and what promotes and maintains it in the most varied domains. Personal and contextual factors are mentioned in the literature, while cognitive skills and intentional practice to achieve excellence stand out; personality variables are also critical to the development and demonstration of excellence. Based on the literature, this study suggests the importance of persistence, emotional control, and openness to experience.

El objetivo de este estudo fue analizar, desde el punto de vista de la Psicología Positiva, las explicaciones de los investigadores de la excelencia humana proponen para su desarrollo y manutencion en los mas variados campos de actividad. Se encontró que los factores personales y contextuales son mencionados, resaltándose las habilidades cognitivas y el rendimiento superior en la práctica deliberada, siendo las variables de personalidad fundamentales para el desarrollo y la demostración de la excelencia. Este estudo, basado en la literatura, destaca la importancia de la persistencia, el control emocional y apertura hacia la experiencia.

Avaliação do Estresse na Obesidade Infantil / Assessment of Stress in Childhood Obesity / Evaluación del Estrés en la Obesidad Infantil

A obesidade infantil é uma doença de causas múltiplas, com repercussões de ordem fisiológica e emocional que pode progredir até a idade adulta. O aumento da obesidade entre as crianças brasileiras está associado ao estilo de vida contemporâneo, que vem se caracterizando pelo sedentarismo e hábitos alimentares inadequados. Entende-se que essa combinação, associada ao estresse, desempenha papel significativo na gênese da obesidade infantil, sendo que os sintomas de estresse variam e dependem da maneira como a criança interpreta e reage às situações do ambiente. Com base nesse entendimento, este trabalho objetivou avaliar o nível de estresse em crianças obesas que frequentam o Instituto de Cardiologia de Porto Alegre. Participaram do estudo 15 crianças com diagnóstico de obesidade, com idades entre oito e 12 anos. Os instrumentos utilizados foram: uma Ficha de Dados Sociodemográficos e de outras informações sobre cada criança, e a Escala de Stress Infantil de Lipp (2005). Sete crianças obtiveram resultados indicativos de estresse (cinco meninas e dois meninos). Os resultados reforçam a expectativa de aumento da obesidade associada ao estresse entre as crianças e sua relação com as alterações do estilo de vida...

Childhood obesity is a disease of multiple causes, with physiological and emotional repercussions that can progress until adulthood. The increase of obesity among Brazilian children is associated to the contemporary lifestyle, characterized by sedentary and inadequate eating habits. It is known that this combination, associated with stress, plays significant role in the genesis of childhood obesity, and that stress symptoms are variable, depending on how the child reacts and interprets the situations of the environment. Therefore, this study had the purpose of evaluating the stress level of obese children that attend Instituto de Cardiologia, in Porto Alegre. Fifteen children with obesity took part in the study, ages from 8 to 12 years old. The instruments used were a Record of Socio-Demographical Data and other important information to understand the child behavior, and the Children Stress Scale (Lipp, 2005). Seven children obtained significant results for stress (five girls and two boys). The results reinforce the expectancy for the increase of obesity associated with stress among children, related to the changes in life style...

La obesidad en la infancia es una enfermedad de múltiples causas, con los efectos fisiológicos y emocionales que puede progresar a la edad adulta. El aumento de la obesidad entre los niños brasileños está asociado con el estilo de la vida contemporánea, que se ha caracterizado por la inactividad y dieta inadecuada. Se entiende que la combinación del con estrés tiene importancia en la génesis de la obesidad infantil, y los síntomas de estrés son variables y dependen de cómo el niño interpreta y reacciona a las situaciones del medio ambiente. En este supuesto, este estudio tuvo como objetivo evaluar el nivel de estrés en niños obesos en el Instituto de Cardiología de Porto Alegre. Los participantes del estudio fueron 15 niños obesos, de edades comprendidas entre los 8 y 12 años. Los instrumentos utilizados fueron una Ficha de Datos Socio-Demográficos y otras informaciónes importantes para comprender el funcionamiento de los niños y la Escala de Estrés para niños de Lipp (2005). Siete niños tuvo resultados de estrés (cinco niñas y dos niños). Los resultados refuerzan la expectativa de un aumento del estrés asociado con la obesidad entre los niños, y su relación con los cambios en el estilo de vida...

Gill histopathological alterations in Nile Tilapia, Oreochromis niloticus exposed to treated sewage Water

Adult Nile tilapia, Oreochromis niloticus, of both sexes were exposed in wastewater from a sewage treatment plant for a period of 4 days. Gill samples were collected after 24, 48, 72 and 96 h and histopathological changes were analyzed by light and scanning electronic microscopy. Gill epithelium of control O. niloticus (freshwater group) was similar to that of other teleosts, while histopathological lesions were observed in exposed fishes. The main histopathological changes were edema, lifting of lamellar and filamentar epithelia and lamellar fusion. Cell proliferation with consequent thickening of the filament epithelium was also found in fishes exposed to the treated sewage water. The severity of the lesions increased with the time of exposure, namely the hyperplasia of the epithelial cells with proliferation of filamentar epithelium and fusion of lamellae observed at 96 h. Additionally, several histopathological results obtained by light microscopy were confirmed through scanning microscopy.

Tilápias adultas, Oreochromis niloticus, de ambos os sexos foram expostas em águas residuais de uma estação de tratamento de esgoto durante 4 dias. Amostras de brânquia foram recolhidas após 24, 48, 72 e 96 h e as alterações histopatológicas foram analisadas por microscopia óptica e eletrônica de varredura. O epitélio da brânquia do grupo controle apresentou uma morfologia similar à de outros peixes teleosteos, enquanto foram observadas lesões nos peixes expostos. As principais alterações histopatológicas foram edema, destacamento dos epitélios lamelar e filamentar e fusão lamelar. Os peixes expostos às águas residuais mostraram também proliferação celular com consequente aumento da espessura do filamento branquial. A severidade das lesões aumentou com o tempo de exposição, nomeadamente a hiperplasia das células epiteliais com proliferação do epitélio filamentar e fusão das lamelas observadas preferencialmente às 96 h. Adicionalmente, alguns dos resultados obtidos pela análise em microscopia de luz foram confirmados com o recurso da microscopia eletrônica de varredura.